Physical exercise is associated with lower t-FM, r-FM, and insulin resistance, which could contribute to the decrease of the risk of cardiovascular and metabolic conditions in individuals with c-SCI.

Severe bone loss is a recognized complication of chronic spinal cord injury (SCI). Physical exercise contributes to bone health; however, its influence on bone mass of cervical SCI individuals has not been investigated. The aim of this study was to investigate the influence of physical activity on bone mass, bone metabolism, and vitamin D status in quadriplegics. Total, lumbar spine (L1-L4), femur and radius bone mineral density (BMD) were assessed in active (n = 15) and sedentary (n = 10) quadriplegic men by dual energy X-ray absorptiometry. Concentrations of 25-hydroxyvitamin D [25(OH)D], PTH, IGF1, osteocalcin and NTx were measured in serum. After adjustments for duration of injury, total body mass, and habitual calcium intake, bone indices were similar between groups, except for L1-L4 BMD Z score that was higher in the sedentary group (P < 0.05). Hours of physical exercise per week correlated positively with 25(OH)D (r = 0.59; P < 0.05) and negatively with PTH (r = -0.50; P < 0.05). Femur BMD was negatively associated with the number of months elapsed between the injury and the onset of physical activity (r = -0.60; P < 0.05). Moreover, in the active subjects, both L1-L4 BMD Z score (r = 0.72; P < 0.01) and radius BMD (r = 0.59; P < 0.05) were positively associated with calcium intake. In this cross-sectional study, both the onset of physical activity after injury and the number of hours dedicated to exercise were able to influence bone density and bone-related hormones in quadriplegic men. Our results also suggest a positive combined effect of exercise and calcium intake on bone health of quadriplegic individuals.

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Objectives: Physical exercise has an important role in reducing body fat, risk of chronic disease and systemic inflammation. The aim of this study was to determine serum leptin and insulin concentrations and their relationship to the time of physical exercise after injury in men with cervical spinal cord injury (c-SCI). Methods: c-SCI subjects with lesion level in C5-C7 (n ¼ 25) were divided into two groups: physically active (PA, n ¼ 13; those who practiced physical exercise for at least 3 months, three times per week or more, for a total minimum of 150 min of physical activity per week) and non-physically active (N-PA, n ¼ 9). Body composition was assessed by dual energy X-ray absorptiometry. Blood samples were obtained 12 h after an overnight fast to measure insulin and leptin in serum, and glucose and C-reactive protein (CRP) in plasma, by validated methods. Results: Comparing the PA and N-PA group, the first presented lower: total body mass ( À13%), body mass index ( À16%), fat mass (kg À39%, FM% À30%), CRP ( À23%), serum insulin ( À61%), homeostasis model assessment (HOMA, À35%) and serum leptin ( À62%; Po0.05). Both serum insulin (r ¼ À0.561; Po0.05) and HOMA (r ¼ À0.591; Po005) were inversely proportional to the time of practice of physical activity after injury. Conclusion: Our results suggest that exercise was able to reduce fat mass and increase insulin sensitivity, decreasing plasma levels of risk factors in c-SCI subjects.

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73Artigo de revisão Resumo A maior fragilidade e o consequente aumento do risco de fraturas que caracterizam a osteoporose são derivados dos processos de perda de massa óssea e deterioração microestrutural ao longo do tempo. Esses processos têm origem complexa e multifatorial, com reconhecida influência predominante de fatores genéticos. Em função de que os tratamentos disponíveis não restauram significativamente o osso já perdido, existe um crescente interesse na prevenção da doença. Garantir condições favoráveis para o ritmo adequado de aquisição óssea na adolescência contribui para o alcance de um pico ótimo de massa óssea no início da vida adulta que, por sua vez, vem sendo considerado o principal método de prevenção da osteoporose. Alguns dos aspectos relevantes para a aquisição óssea do adolescente são tratados nessa revisão. Nutrição, atividade física e condições fisiológicas associadas à adolescência com potencial impacto sobre a taxa de acúmulo ósseo nesse período são abordadas. A potencial influência da composição corporal é também discutida. Abstract Nutrition and other relevant aspects for bone health in adolescenceThe increase in bone fragility and susceptibility to fracture that characterize osteoporosis are derived from the processes of bone loss and micro architectural deterioration over time. These processes have complex and multifactorial origin with recognized predominant influence of genetic factors. Considering that available treatments do not significantly restore bone already lost, there is a growing interest in preventing the disease. Ensuring conditions that favor an adequate bone mass acquisition in adolescence contributes to the achievement of an optimal peak bone mass in early adulthood, which has been considered the primary method of preventing osteoporosis later in life. Some of the relevant aspects for adolescent bone acquisition are considered in this review. Nutrition, physical activity and physiological conditions associated with adolescence with potential impact on bone accumulation rate in this period are addressed. The potential influence of body composition is also discussed.Keywords: Bone density; Adolescent nutrition; Body composition; Osteoporosis. Nutrição e outros aspectos relevantes para a saúde óssea na adolescência ResumenNutrición y otros aspectos relevantes para la salud ósea en la adolescencia La mayor fragilidad ósea y el consiguiente aumento del riesgo de fracturas que caracterizan la osteoporosis se derivan de los procesos de pérdida de masa ósea y deterioro micro estructural a lo largo del tiempo. Estos procesos tienen origen complejo y multifactorial con reconocida influencia predominante de los factores genéticos. Ya que los tratamientos disponibles no restauran significativamente el hueso ya perdido, hay un creciente interés en la prevención de la enfermedad. Garantizar condiciones que favorezcan el ritmo adecuado de adquisición ósea durante la adolescencia, contribuye a alcanzar un máxi-mo óptimo de masa ósea en la edad adulta temprana, que a su vez ha s...

We evaluated bone mass adequacy and its association with waist and hip circumferences in Brazilian post‐menopausal women stratified by self‐reported skin color. Participants (n=161, mean age 57y) were part of a university staff cohort at Rio de Janeiro (the Pró‐Saúde study). Bone mineral content (BMC) and density (BMD) of total body (TB), lumbar spine (L1‐L4), total hip (TH) and femoral neck (FN) were assessed by DXA. Waist and hip circumferences were measured using standard methods. Differences between skin color groups (black, n=48; brown, n=47 and white, n=66) were evaluated by one‐way ANOVA. Associations between bone parameters and waist or hip circumferences were investigated by Pearson´s and by partial correlation. Prevalence of osteopenia and osteoporosis were 38% and 3%, respectively. TB, TH and FN BMD T‐scores were higher in black compared to white women (P<0.05). Waist and hip circumferences correlated positively with BMC, BMD and BMD T‐score at all bone sites in all skin color groups (r蠅0.29; P<0.05). After adjustment for weight and post‐menopausal period, associations between bone parameters and waist and/or hip circumferences were not significant or, in the case of white women, became negative (r蠄‐0.29; P<0.05) for TB and TH BMC, BMD and BMD T‐scores. Our results indicate higher bone mass in blacks compared to brown and white post‐menopausal women and suggest that waist and hip adiposity may be detrimental to bone mass, especially in white women. Grant Funding Source: Supported by CAPES, FAPERJ (Brazil)